NPI | 1942422944 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 125-049933) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME 017827) |
Enumeration Date | 2007-05-02 |
Last Update Date | 2015-09-01 |